Pediatric Dentistry

"Pediatric Dentistry is an age-defined specialty that provides primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs."

The key elements of this definition

• "age-defined": most specialties are procedure defined (endodontics, periodontics, etc.). Pediatric dentists provide care for their specific age group of patients. There is no limitation to what type of treatment they provide.
• "primary and comprehensive...care": Pediatric dentists are primary providers. There is no need for a referral of patients. Parents can choose to have their children evaluated and treated by a pediatric dentist just like they can choose to have their child treated by a pediatrician.
• "infants and children through adolescence": Pediatric dentists see patients at any age from birth up to their late teens.
• "special health care needs": Pediatric dentists have the training and experience to evaluate and treat patients, that are medically compromised. This includes patients with hemophilia, leukemia, congenital syndromes, etc... No other dental specialty, other than OMS is more involved in hospital care of patients.

Pediatric dentistry is an age-defined specialty that provides both preventive and therapeutic dental care for infants, children and adolescents.

Pediatric dentists are the pediatricians of dentistry. After completing dental school, we are further trained for the unique dental health needs of children. Our specialized education consists of child psychology, growth and development, management of oral-facial trauma, sedation and general anesthesia.

At Children's Hospital Boston, our Pediatric Dentistry Service is designed to help children feel at home and comfortable, and our experienced dental staff is trained to respond to the special concerns and needs of our patients. Children are offered the opportunity to see, touch and operate all of the dental equipment.

All children are not alike! Our pediatric dentists provide an ongoing assessment of the changes in your child's oral health. As experts in dental development, we monitor your child's needs and provide advice and treatment to ensure a winning smile. From teething infants to appearance-conscious teenagers, the pediatric dentists at Children's Hospital Boston provide dental care based on comprehensive dental research and extensive clinical experience.

Maintaining disease-free teeth and gums is a major goal of the pediatric dentist. To help prevent tooth decay, we make sure our patients receive optimum fluoride exposure and we apply pit and fissure sealants when appropriate. In addition, our dental staff demonstrates proper brushing and flossing techniques and assists patients and their families in identifying foods that promote tooth decay. The total care your child receives in our department will serve as a motivating force, promoting good oral health habits that can be maintained for a lifetime.

Pediatric Dentist

A pediatric dentist is a dental specialist that has not only completed 4 years of dental school, but has also completed an additional 2 to 3 years of specialty training to treat children only.
Many general dentists treat children as well as adults, but a pediatric dentist only treats children.The goal of a pediatric dentist is to teach children the importance of oral hygiene, how to take care of their teeth and to help children feel comfortable about visiting the dentist.
Many pediatric dentists do not allow parents to go back in the treatment rooms with the children. If this is a big issue for you, be sure to ask this question if you are looking for a pediatric dentist.

Infants and children are not immune to oral health problems. In 2002, "Oral Health in America: A Report of the Surgeon General" found that dental caries (tooth decay or cavities) is the most chronic childhood ailment — five times more common than asthma and seven times more common than hay fever.
In 2005, The Centers for Disease Control and Prevention found that tooth decay is the most chronic disease among children aged five to 17. Oral health problems affecting infants are no less serious.

Diet and the Oral Health Implications

What your children eat affects their teeth. Sugars (found in cake, cookies, candy, milk and juice) and starches (found in pretzels and potato chips) can cause tooth decay. Add to this the fact that it is more difficult to clean babies' and children's teeth and you can see why debris tends to remain in children's teeth, resulting in bacteria growth and, ultimately, tooth decay.
Although baby teeth (deciduous or primary teeth) are eventually replaced with permanent teeth, healthy baby teeth are fundamental to a child's overall health and development.
Baby-to-Child Dental Checklist

Some babies are born with neonatal teeth (teeth that develop in the first month) that require dental hygiene or a visit to the dentist for their removal. At least one baby tooth erupts by six months of age. And, yes, it requires cleaning.

From six months to 24 months, children begin teething in earnest, indicated by irritability, biting on objects, drooling and ear pulling. As a parent, you can help teething progress by using strategies such as massaging your child's gums, offering a chilled teething ring or cold, wet washcloth and asking your dentist for a teething ointment recommendation.
By three years of age, most if not all baby teeth have erupted. Soon after four years, spaces for permanent teeth begin to appear as the jaw, supporting bone structure and facial bones begin to grow.

From six to 12, it is typical for your child to have both baby teeth and permanent teeth in their mouth.
Oral Health Care Necessities for Children & Infants
Here's a list of dental care necessities from birth on up:

Children should be encouraged to brush their own teeth once they have the coordination to do so.

Baby Teeth Cleaning: Baby teeth should be cleaned as soon as they erupt. Clean your baby's teeth with a soft washcloth or gauze after every bottle or meal. When more than one tooth erupts, you can soak a small-bristled child-sized (age-appropriate) toothbrush in warm water before using it on your baby's teeth, as instructed by your dentist.

Baby teeth should be brushed using a pea-sized amount of toothpaste. Use water without fluoride until approximately six months of age. Encourage your children to brush their own teeth once they have the coordination to do so. Replace toothbrushes every two to three months.
Children’s teeth should be brushed after they are given medicine. Acids contained in medicines may eat away at tooth enamel, which serves as a natural protective coating for the teeth.
First Dental Visit: It is important that your child see a dentist by age one to establish a long-term dental hygiene and professional dental cleaning plan.
Dental Sealant Application: Dental sealants are used to protect teeth from decay and are appropriate as soon as a tooth erupts.

Fluoride Treatments: Check with your dentist and water authority about the need for fluoride treatments. Fluoride is a major component in the prevention of childhood dental caries. This is because fluoride alters the molecular structure of the tooth, making it more resistant to acid attack and decay.
However, children require the right balance of fluoride treatment. Too much fluoride could be problematic and lead to fluorosis.

Dental Flossing: Parent-assisted dental flossing should commence when two teeth erupt next to each other. Independent flossing should occur when children have the ability to do it on their own (often by six years of age).
Mouth Washing: Mouth washing is usually recommended by age seven, provided your child can perform the activity.

Orthodontics: Orthodontics may be appropriate by seven years of age.

When Do Baby Teeth Erupt?

Upper
A - Central Incisors - 8-13 months
B - Lateral Incisors - 8-13 months
C - Canines (cuspids) -16-23 months
D - First Molars - 13-19 months
E - Second Molars - 25-33 months

Lower
A - Central Incisors - 6-10 months
B - Lateral Incisors - 10-16 months
C - Canines (cuspids) - 16-23 months
D - First Molars - 13-19 months
E - Second Molars - 23-31 months

Baby Teeth Basics

Since babies don’t come with instructions, it’s important for parents to learn the basics about caring for all aspects their children’s health, including dental care. The information provided here will answer some common concerns about baby teeth, also known as primary teeth.

Are Baby Teeth Really Important?

Yes, yes and yes! I have seen many parents opt to pull their child’s baby tooth rather than fill a cavity because “it is only a baby tooth and will come out eventually anyway.” Baby teeth serve important purposes such as helping the child to speak normal and clear, and to chew naturally. Baby teeth also hold a place for permanent teeth to come in properly.

Will Pacifiers and Thumb Sucking Harm My Baby’s Teeth?
According to the Academy of Pediatric Dentistry, pacifiers and thumb sucking only present a problem if they persist for a long time, such as when the permanent teeth began to arrive.
Can I Brush My Baby’s Teeth?

Yes, but without toothpaste. You can use a small toothbrush with soft bristles at bedtime to remove plaque and bacteria. Instead of using toothpaste, just use a small amount of water. There are several soft bristled toothbrushes on the market that are designed specifically for infants.
When Can I Use Toothpaste for my Child?

At age two or three, a child should be ready to use toothpaste with fluoride. It is very important that only a small amount of toothpaste is used, such as the amount of a pea. The child should also be watched while brushing to be sure they spit out the excess toothpaste instead of swallowing it.
What Is the Proper way to Brush my Child’s Teeth?

Brushing your children’s teeth at least twice a day is very important, but it should also be done properly. This easy step by step guide with photos will show you the proper way to brush your child’s teeth.
When Should I Take My Child to the Dentist for the First Time?
According to the American Academy of Pediatric Dentistry, children should visit a pediatric dentist when their first tooth comes in or no later than their first birthday.

What Is a Pediatric Dentist?

A pediatric dentist is a dental specialist that has not only completed four years of dental school, but has also completed an additional 2 to 3 years of specialty training to treat children only.

Many general dentists treat children as well as adults, but a pediatric dentist only treats children. The goal of a pediatric dentist is to teach children the importance of oral hygiene, how to take care of their teeth and to help children feel comfortable about visiting the dentist.

Many pediatric dentists do not allow parents to go back in the treatment rooms with the children. If this is a big issue for you, be sure to ask this question if you are looking for a pediatric dentist.

How Often Should my Child Have a Dental Check Up?

Most children should see their dentist for a regular cleaning and check up every six months. Your dentist will determine if there are any special circumstances that might require more frequent visits.

What Will Happen at My Child’s Check Up?

Many children are terrified of the dentist, but going to the dentist doesn't have to be scary if they know what to expect. These photos will show you and your children what happens at the dentist for a routine check up and cleaning.
When Will my Child get Permanent Teeth?
This chart will show you which permanent teeth your child should be getting at specific ages.